Department of General Surgery, The Second Xiangya Hospital, Central South University, No.139 Middle Renmin Road, Changsha, Hunan, 410011, P.R. China.
Sci Rep. 2020 Jun 15;10(1):9621. doi: 10.1038/s41598-020-66722-2.
To analyze the initial learning curve (LC) for robot-assisted pancreaticoduodenectomy (RAPD) and compare RAPD during the initial LC with open pancreaticoduodenectomy (OPD) in terms of outcome. This study is a retrospective review of patients who consecutively underwent RAPD and OPD between October 2015 and January 2020 in our hospital. 41 consecutive RAPD cases and 53 consecutive open cases were enrolled for review. Compared with OPD, RAPD required a significantly longer operative time (401.1 ± 127.5 vs. 230.8 ± 44.5 min, P < 0.001) and higher cost (194621 ± 78342 vs. 121874 ± 39973 CNY, P < 0.001). Moreover, compared with the OPD group, the RAPD group revealed a significantly smaller mean number of lymph nodes harvested in malignant cases (15.6 ± 5.9 vs 18.9 ± 7.3, P = 0.025). No statistically significant differences were observed between the two groups in terms of incidence of Clavien-Dindo grade III-V morbidities and 90-day mortality and readmission (P>0.05). In the CUSUM graph, one peak point was observed at the 8th case, after which the operation time began to decrease. LC for RAPD may be less than 30 cases, and RAPD is safe and feasible during the initial LC.
分析机器人辅助胰十二指肠切除术（RAPD）的初始学习曲线，并比较 RAPD 在初始学习曲线期间与开放胰十二指肠切除术（OPD）在结果方面的差异。本研究回顾性分析了 2015 年 10 月至 2020 年 1 月期间在我院连续接受 RAPD 和 OPD 的患者。共纳入 41 例连续 RAPD 病例和 53 例连续开放病例进行回顾性分析。与 OPD 相比，RAPD 手术时间明显更长（401.1±127.5 比 230.8±44.5 min，P<0.001），费用更高（194621±78342 比 121874±39973 元，P<0.001）。此外，与 OPD 组相比，RAPD 组在恶性肿瘤病例中平均采集的淋巴结数量明显较少（15.6±5.9 比 18.9±7.3，P=0.025）。两组在 Clavien-Dindo 分级 III-V 并发症发生率和 90 天死亡率和再入院率方面无统计学差异（P>0.05）。在累积和图中，在第 8 例时观察到一个峰值点，之后手术时间开始下降。RAPD 的学习曲线可能少于 30 例，在初始学习曲线期间 RAPD 是安全可行的。
